American Oral Cancer Clinic

American Dental Association - Recommends “Evidence-Based Dentistry”

A recent posting on the American Dental Association web site describes an interesting study conducted by a panel convened by the ADA Council on Scientific Affairs, a sub-group of the American Dental Association.

The panel, in conjunction with the ADA Center for Evidence-Based Dentistry (EBD)  staff, reviewed five systematic reviews and four clinical studies to determine if dentists could detect oral cancers early through routine dental examination.

The study panel examined four distinct questions in the detection of oral squamous cell carcinomas during routine dental exams:

1. Does routine dental screening reduce the likelihood of potentially malignant lesions on the tongue, cheeks, lips, gums and other parts of the oral cavity?

2. Do specialized treatments help dentists identify potential cancers during routine examinations?

3. Compared to examinations without specialized detection tools, can dentists identify trouble spots or should dentists use these specialized tools for the early detection of squamous cell carcinomas in the mouth?

4. Are there specific groups which benefit more from detailed, dental examinations – groups such as seniors, smokers, men, women and other groups within the larger study group?

According to the panel’s report, “…while oral cancer screenings may detect potentially malignant and malignant lesions, clinicians are urged to remain alert to signs the lesions may become cancerous or early stage cancers while performing routine visual and tactile examinations in all patients, particularly those who use tobacco or consume alcohol heavily.”

It’s been shown that any kind of tobacco use is a cause for potential oral cancers and, when combined with alcohol, people who use tobacco and alcohol in conjunction, are 15 times more likely to be one of the 30,000 men and women diagnosed with tongue cancer or some other form or oral cancer this year.

In plain English, the panel set out to determine if dentists who examine patients for early signs of cancer increased chances of early detection and the conclusion, reported on the ADA web site, is that, indeed, dentists are often in the best position to detect potential cancerous lesions during routine dental examinations.

Dr. Michael Rethman, who undertook the study, stated, “"What's most important is that this (review) points to the need for more research on the natural history of squamous cell carcinomas in the mouth and the epidemiology of oral cancer.

We still don't understand the answers to a lot of fundamental questions like the progression of the disease and whether intervention helps. It's plausible that early diagnosis helps, but we don't even know that.

There's an incredible need for more research on this topic," Dr. Rethman concluded.

What Is Evidence-Based Dentistry?

EBD is a systematic approach to the delivery of dental care involving four main considerations:

7 Simple Tips to Detect Oral Cancer – EARLY! Self-Exams Save Lives

Our bodies are changing all the time as we age, going from infant and toddler to active senior still in the game. So changes to various body parts are routine. We may see a new mole, but not recognize it as a potential danger sign of a simple skin cancer. Men may visit the bathroom 30 times a day due to an enlarged prostate gland and either choose to live with it or simply accept frequent urination as part of the aging process.

Living with changes, or ignoring change, is especially true of oral cancers – cancer of the tongue, lips, checks, esophagus, larynx and other body bits around your mouth. As with all cancers, the earlier a cancer is detected and treatment undertaken, the better the outcomes. This is especially true of tongue cancer and other oral cancers, yet how often do we examine ourselves for early signs of tongue cancer?  Like never?

You’re the one most familiar with your body and the changes and phases it goes through. You’re also in the best position to discover changes that may indicate a form of oral cancer is present since you spend more time looking at your mouth than anyone else.

So, what to look for? Well, oncologists – medical doctors who specialize in the prevention and treatment of cancer, have some suggestions. These tips for self examination don’t take long, they don’t hurt, you can do them yourself and, in the process, make yourself a strong advocate for your own good health.

Here are seven simple self-examine steps you can take to help identify oral cancers in their earliest stages, so you can get yourself into a treatment program NOW!

1. Tongue and floor of the mouth

• Look in a mirror and stick out your tongue.

• Examine the upper surface of the tongue for any unusual lumps or obvious changes in color. Dark blotches, for example, on the upper surface of the tongue should be examined.

• Pull the tongue forward and examine the sides for lumps, bumps, masses and, again, obvious changes in skin color or texture. If you discover any obvious swelling, see a doctor. Oral cancers are often painless, making them difficult to diagnosis based on pain. But you can see oral cancer, in many instances, early enough to solve the problem as an out patient. How cool is that?!

• Examine the underside of your tongue by placing the tip of your tongue on the roof of your mouth. Same procedure. See any unusual bumps, lumps, swelling or changes in skin color.

• Your tongue should have a uniform texture and uniform color. Glide you finger along the underside of your tongue to feel for unseen bumps. Any deviation should be examined by your family doctor first to see if a visit to an oncologist is step #2.

2. Examine the roof of your mouth.

The roof of the mouth is easy to examine with your eyes and with your fingers. Tilt your head back as you stand in front of a mirror. Position yourself so you get a good view of the entire upper mouth.

Perform a visual exam for discoloration. Then gently slide your finger over the roof of your mouth feeling for any kind of protrusion. (Pizza blisters don’t count.) If you feel anything out of the ordinary, report to your doctor stat!

3. Check your cheeks.

Visually inspect your cheeks. Extend them (be gentle) to look for red, white or dark-colored patches.

Next, place your forefinger on the interior check and your thumb on the outer cheek. Gently squeeze as you rotate you fingers across the entire cheek. This is the best way to detect lumps, bumps or swelling – through the sense of touch. Cheek cancer can often be felt before there are any visible symptoms.

4. Head and Neck

Stand with your head straight up in front of a mirror.

Usually, your face is uniform, i.e., has the same shape on both sides. However, a lump, bump or other protrusion on one side of the face is a definite signal to see your doctor. It may be nothing, it may be something. In either case, it’s worth checking out and a visit to your family doctor is the best place to start when you first detect unevenness within your facial structure.

5. Lips

The lips are highly sensitive to sunlight and lip cancer is one possible (and unfortunate) result. Open your mouth and examine both the outer and inner lip for changes in color or texture.

Gently extend you lips to get the best view of the interior lip area. (You may have to do a little twisting to get the view you want. If so, use a hand mirror to get a good look at the interior lip surface.) Discoloration and protrusions are sometimes early indications of lip cancer.

However, you accidently bite your lip, the lips are constantly moving as you talk, you moisten your lips with your tongue and so on, so expect to see changes. Even the seasons change the exterior portion of the lip so dried lips in the middle of winter aren’t a sign of cancer, though you may want to get some chap stick to keep lips moist.

6. Neck Area

This is where the esophagus and larynx are located, but we can’t see that far down our own throats, even if we stand on our heads. (Please don’t try this at home.)

However, using a feather-light touch, gently slide you fingers along the sides and front of your neck feeling for any lumps that you discover on one side of your neck but not the other. Use your finger tips to gently glide over the skin of your neck feeling for anything out of the ordinary.

Next, apply a small amount of pressure as you slide your fingers over the skin. This time note any tenderness, soreness of swelling. So, first a gentle exam, and then add a little pressure to identify any soreness or swelling.

7. A Persistent Cough

You can feel it and hear it – a cough that just doesn’t go away. Often, you chalk it up to a cold, but you don’t have any symptoms of a cold. Just that cough.

Smokers (28% of Americans still smoke despite all the solid evidence that smoking is bad for just about every part of your body) may experience “smoker’s” cough that comes and goes. This often occurs when the upper portion of the lungs become irritated.

It also occurs when the airway to the lungs becomes irritated and inflamed. Most smokers just live with it, though for many, not as long.

Quitting, even for a couple of days, will sometimes clear up a case of smoker’s cough but if you still have a scratchy sore throat even though you’ve given up smoking until your throat feels better, make an appointment to see your doctor.

There are some other things you can do to ensure early detection of oral cancers beside kicking butt. Ask your dentist to perform an examine each time you’re in for a cleaning. Some dental professionals perform this examine routinely. All will be happy to give your mouth and throat a good look if you ask.

Tongue Cancer: 8 Ways to Make It A Family Affair

Get the Support You Need After a Tongue Cancer Diagnosis from your Family

“You have tongue cancer.”

In the time it takes to hear those words, lives change forever. The folks who receive the dreaded diagnosis instantly become reluctant members of the Big C Club – the club no one joins voluntarily. Cancer of the tongue, the esophagus, gums or larynx changes individuals’ lives permanently.

However, the new cancer patient isn’t the only one impacted by the diagnosis of tongue cancer or other oral cancers. You better believe, it’s going to impact the entire family, social networks, work groups and people who suddenly view themselves as “victims.”

Living with oral cancer is difficult, despite improved outcomes, especially when the disease is caught early. With today’s computer-aided surgical options, oral surgeons can aggressively go after the cancer through the use of laser surgery, more precise radiation treatments and chemo with fewer negative side effects (and a lot more positive affects thanks to on-going reasons into how and why oral cancers develop.)

So, how do you keep life on an even keel after a loved ones receives the frightening diagnosis: “You have cancer of the lip.”

1. Recognize the stages the new patient passes through.

Routinely, new cancer patients go through various phases, ultimately leading to acceptance. Disbelief and denial, deal making with the god of choice, anger (and even mis-directed rage), and, ultimately, acceptance. In fact, many cancer patients report a feeling off calmness when they reach this Zen-like state. What will be will be, one day at a time.

Adapt to the emotions of the patient. If your spouse grumbles that dinner isn’t ready, don’t lash out. Recognize that your spouse isn’t angry that dinner isn’t ready. She’s angry because she’s fighting a battle against cancer and life doesn’t seem fair.

2. Build a support network.

Friends, family, neighbors – all can pitch in and tend to the patients’ needs. As a family member (the only grown-up in the household), you may feel that the full weight of in-family tongue cancer has landed squarely on your shoulders. It hasn’t.

Never be afraid to ask loved ones to help. THEY WANT TO HELP. JUST TELL THEM WHAT YOU NEED DONE!

Expand the support network by joining community groups of cancer survivors. There’s nothing more motivational than hearing how a neighbor fought cancer for 15 years and is now cancer free. That’s motivational.

3. Assess and respect the patient's needs.

Some people react with a “come what may” attitude, others are terrified to death – of death. As a family member, it’s easy to assess what the cancer patient needs.

Some just want a willing ear to listen. At these times, it’s difficult NOT to offer suggestions but, in many cases, the patient just wants to talk. Learn what your family member wants. If she spends two weeks in a darkened room, well, that’s how she deals with a cancer diagnosis. Don’t try to force the patient through the various stages of denial to acceptance. These stages of psychological feeling evolve one into the other without any help from you.

And never say things like “Everything will be alright.” The patient may be made to feel weak or a quitter because she sure doesn’t feel like evertyhing’ll be alright – at least at the moment.

Listen patiently and support your family members feelings. Respect them. They’re the feelings most cancer patients feel upon receipt of that Big C heads up. “Oh, by the way, we found a tumor on your larynx.” Your family member or friend, co-worker or neighbor often just wants to talk without any input. This kind of therapy helps cancer patients to move more smoothly through the emotional stages of being a cancer patient.

4. Maintain household routines

Routines help us maintain order in our lives, enabling us to wake up, trod down stairs in our slippers, start the coffee, let out the dog, feed the cat and get the morning paper – before we’re even awake. Routines (some call them ruts) enable people to multi-task, performing some activities by rote while thinking about two or three other things as we prepare our world famous meat loaf for the 1,000th  time.

Expect changes in routine. Visits to physicians, surgeons, radiologists, oncologists and professional counselors trained to help new cancer patients adapt and quickly – to their new circumstances.

5. I’m your wife, not a victim!

One of the worst parts of becoming a member of the Big C Club is that people’s perception of you changes. You go from husband or wife, mother or father, faithful friend or reliable co-worker to cancer victim. Overnight.

And victims FEEL victimized. Treat cancer patients in your life as you normally would. Let the patient take the lead. If he wants to talk about it over lunch, ask for more breadsticks and listen with compassion and patience. But NOT pity.

Cancer patients don’t want your pity. They want your support so don’t change the way you view your cancer-stricken family member, friend or neighbor, Treat them as you always have. Let them know that you’re an ally, available to help and then let the patient chart the course.

If he wants to talk about it, he will. (See being a good listener above.) It’s not about finding solutions. That’s what the medical community does so be there for emotional support, psychological support, love and a big hug. That’s all the patient needs to know.

6. Never play down the feelings of the patient.

Let them cry. Let them release the stress. Let them be enraged. Listen attentively but never tell the cancer patient to “buck up.” You aren’t the one with the cancer diagnosis so best to keep your mouth closed.

7. Accompany the cancer patient on each visit to a medical professional.

Patients – educated patients – are their own best advocates. However, when you’re scared about an unknown future, all that important information – names, dates, appointments, a step-by-step analysis of treatment options  - may get lost.

Information overload.

The Psychology of Cancer: Mind Over Matter

A cancer diagnosis is a life-changing event. One minute, you’re just you, diagnosis is made, you’re now a cancer survivor. Wow, that didn’t take long. And as devastating as that cancer diagnosis is, it isn’t a death sentence. Far from it. There are millions of cancer survivors around the globe enjoying rich, full, LONG lives thanks to advances in treatment options.

An article in Psychology Today points out that one of the most controversial treatment options also delivers the most positive results in more and more people with the Big C diagnosis. The article, first, points out that 50% of men and 33% of women face the prospect of a cancer diagnosis. Hmmm, that can’t be good.

However, the Psychology Today article wasn’t about the widespread nature of cancer. Nope, this article was about the psychology associated with receiving that dreaded diagnosis. More specifically, this informative piece describes the success oncologists and other cancer specialists are seeing in a change in patient psychology.

Psychology and Stress Levels

Hey, you just got a diagnosis of cancer. You’re bound to be stressed to the max. Who wouldn’t be?

However, today, psychologists are brought in to the treatment team to help both patient and family members discover how to cope with the added stress a cancer diagnosis delivers to everyone associated with the actual cancer patient. Many times, the diagnosis is more difficult on family and loved ones than on the patient!

The Psychology Today article also points out that there’s enough solid evidence to suggest that psychology may actually increase the patient’s immune system and extend life – sometimes for decades. Mind over matter folks. There’s been a long-known correlation between the physical and the psychological – the brain. Sure, they’re distinct. But, the brain and body work in conjunction 24/7 so it’s safe to assume that negative emotions, like stress, will make a difficult situation worse for the patient and the family.

One Women’s Story

One patient, mentioned in the Psychology Today article, was diagnosed with breast cancer in 1986. “I was stunned. I spent my lunch hours working out. I ate good things. I was a health nut.”

The patient underwent a mastectomy and, purely by chance, she met a psychologist at the Ontario Cancer Institute.

The patient worked with the psychologist in both private, one-on-one meetings and in support groups that transformed the patients life. She wasn’t alone. She wasn’t singled out. And she discovered that she had a lot to live for.

Together, the patient and the psychologist developed a program of meditation and other relaxation techniques. She also participated in group sessions to learn better how to cope with the grief, fear, depression, anger and “woe-is-me” view that cancer had somehow grabbed her, shook up her life and had pronounced a death sentence.

With the help of the group, by listening to the experiences of others in the same boat, this women learned to live her life – to take control of her life again and not let the cancer diagnosis turn her into a victim. She was in charge, and thanks to the support group and one on one sessions with a psychologist, she conquered cancer.

Sadly, when her cancer returned in 1990, her doctor “gave” her three months to live. “It was the skills I learned that got me through – and continue to get through.” When she applied the mind over matter approach she’d learned from 1986 though 1990 that prepared her for a second devastating diagnosis. The cancer had returned like some unseen, terrifying monster.

Only this time, using the skills, exercises and attitude changes that she’d learned through the Ontario Cancer Institute, she took this second diagnosis of the return of cancer in stride. In fact, this individual went totally pro-active.

First, she stopped all physical treatment. No more chemo or radiation. Why should she continue with these treatment options when they didn’t work in the first place? Makes sense, right?

She spent her time meditating and focusing on the positives in her life, living each day to the fullest. (When a doctor tells you that you’ve got three months to live, you BETTER live each day to fullest and appreciate every sunrise, sunset, thunderstorm and the buzzing of the bees.)

Tongue Cancer Support Groups: 5 Reasons You Are NEVER Alone

A cancer diagnosis is devastating.

Just yesterday, life was normal. Then, a visit to your physician changes everything. “I’m afraid you have cancer of the tongue.” The patient’s life changes in an instant. What was normal is no longer routine. You feel out of control and under attack. Often, you don’t know where to turn.

For many, talking about their condition with family and friends only causes more stress and anxiety for loved ones. So, you pretend that nothing has changed. But it has. And talking about your condition with others is positive therapy. But where do you turn? Who can provide that emotional support so vital improved outcomes?

The answer is simple: you engage people who are experiencing the same thing you are – the fear of the unknown, mortality, a loss of control and a feeling of isolation. Cancer support groups provide a secure environment to talk about your condition and your feelings with people who understand implicitly.

They’re in the same boat. They understand how you feel and what you’re going through because they feel the same way and they’re going through the same treatments and experiencing the same loss of control as you experience.

There are cancer support groups in even small communities – groups that will welcome you, listen to you and encourage you during tough times. Joining one of these groups eliminates those feelings of loneliness and lessens the fear of the future. Talking about your condition with people in similar positions provides an emotional lift when you need it most.

Let’s take a closer look at the advantages of joining a cancer support group. Then, pick up the telephone to find a support group near you. All you have to do is show up.

1. Coping with emotions.

While cancer is a physiological condition, it also has a significant impact on your emotional state. A support group helps you better understand these emotions and to recognize that your feelings are the norm. When others share their feelings, their fears, their hopes for the future, you realize that you aren’t alone.

There are many men and women going through the same thing you are. Overnight, they’ve become cancer “victims.” People look at them differently, they act differently around them and cancer becomes the topic of conversation whenever you talk to friends and family.

Members of a cancer support group understand these dramatic changes in your life. They’ve experienced the same changes. However, you aren’t different when you belong to a cancer support group. You’re just one of the gang – a member of a group that “gets it.”

These groups are also great sources of medical information. You’ll learn about various treatment options and outcomes. Members swap stories of what a pain chemo is or how fatigued they feel after radiation treatment. Just knowing that your feelings are similar to those in your support group is comforting.

2. You’ll make new friends.

Cancer support groups encourage bonding with other individuals who have received a cancer diagnosis. It won’t take long to make friends – friends you can call or have lunch with and pick up a little support from someone who won’t find your cancer the center of conversation.

These new friends would rather talk about sports or work or family or shopping – anything BUT cancer. Joining a cancer support group puts you in good company – people just like you. People who want to be supportive no matter how you feel that day. They know that the next day they may be calling you to blow off a little steam or to talk about that day’s treatment.

These friends put joy back into your life and offer the opportunity to forget you’re a cancer “victim.” Instead, you’re you again and cancer isn’t on that day’s list of discussion points.

3. Cancer support groups educate family and friends.